Samplex Flashcards by UPCM 2018

The nerve plexus that controls GI propulsion is located in the:

a. serosa
b. muscularis mucosa
c. submucosa
d. mucosa

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Inhibitory neurotransmitters of GI smooth muscle include:

a. Substance P, ATP, NO
b. ATP, NO, VIP
c. NO, VIP, Ach
d. VIP, Ach, Substance P

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The gastric pacemaker zone is located in the gastric:

a. fundus
b. cardia
c. body
d. antrum

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The nonzero resting baseline tension of GI smooth muscles is:

a. receptive relaxation
b. retrograde replusion
c. tone
d. sieving function

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Retching and vomiting involve all the following physiological responses except:

a. descent of diaphragm
b. stimulation of gastric motility
c. relaxation of UES
d. closure of glottis

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UES pressure is increased by:

a. anesthesia and stress
b. sleep and esophageal distention
c. esophageal distention and stress
d. sleep and anesthesia

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Secondary esophageal peristalsis is stimulated by

a. sleep
b. swallowing
c. esophageal distention
d. sexual activity

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The following statements are true regarding interstitial cells of Cajal except:

a. their function is abolished by vagotomy
b. they have characteristics of fibroblasts and smooth muscle cells
c. they coordinate electrical activity of the GI muscle
d. they generate slow waves in GI smooth muscles

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Which of the following isocaloric meals will be emptied first by the stomach?

a. carbohydrates
b. protein
c. fat
d. fat and carbohydrates

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Which of the following factors will stimulate the enterogastric reflex?

a. gastrin
b. duodenal activity
c. AOTA
d. NOTA

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Which of the following phases of swallowing is resporation-inhibited?

a. fundal
b. esophageal
c. pharyngeal
d. oral

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Which is H+ dependent?

a. galactose
b. fructose
c. amino acids
d. dipeptides

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Absorption of glucose involves:

a. SGTP1 apical, GLUT2 basolateral
b. SGTP1 apical, GLUT5 basolateral
c. SGTP1 basolateral, GLUT2 apical
d. SGTP1 basolateral, GLUT5 apical

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Which voluntary processes can initiate defecation when conditions are appropriate?

a. rectal contraction
b. mass movements
c. EAS relaxation
d. increase of anorectal angle

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GI pacemakers are the:

a. D cells of intestines
b. interstitial cells of Cajal
c. NO synthetase entering neurons of the ENS
d. enterochromaffin cells of the stomach

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The orad contractions of the peristaltic reflex are mediated by:

a. Ach and tachykinin
b. Ach and VIP
c. VIP and NO
d. NO and tachykinin

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The most important factor that causes vomiting is

a. UES relaxation
b. descent of the diaphragm
c. contraction of the abdominal muscles
d. elevation of the soft palate

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Secretion of electrolytes into the GI lumen is mainly through which transport system?

a. Na-K ATPase
b. Ca+ channel
c. Cl- channel
d, Na-K-Cl cotransport

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Iron is stored in tissues as

a. motilferrin
b. transferrin
c. ferritin
d. divalent cationic transporter

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Iron absorption will be increased by:

a. oxalate
b. pytalases
c. ascorbic acid
d. iron overload

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Which of the following steps in calcium absorption is vitamin D dependent?

a. paracellular absorption of Ca++
b. Conduction of Ca++ in the apical membrane
c. calbindin synthesis
d. exit of Ca++ via Na-Ca exchanger

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Which protein will bind Ca transcellularly after entering the apical membrane of the enterocyte

a. caldesmin
b. calmodulin
c. calbindin
d. calporin

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Which transporter is responsible for Na+ coupled uptake of glucose in the apical membrane

a. SGLT1
b. GLUT2
c. GLUT3
d. GLUT5

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Luminal digestion is not necessary for the digestion of:

a. starch
b. lactose
c. amylase
d. protein

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Which of the following is not true regarding MMC

a. It is a cyclical pattern every 90-120 minutes
b. It involves only the stomach
c. It functions in housekeeping
d. It is stimulated by motilin

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Which enzyme for protein digestion is secreted by the stomach and activated by HCl

a. amylase
b. trypsinogen
c. pepsinogen
d. elastase

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Protein digestion begins in the

a. mouth
b. esophagus
c. stomach
d. small intestine

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True of the motility of the sphincter of Oddi

a. relaxed most of the time
b. prevent reflux of duodenal contents into the pancreatic duct
c. pressure is less than that of pancreatic duct
d. relaxed by somatostatin after meals

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Procarboxypeptidase and proelastase are activated by

a. HCl
b. ribonuclease
c. enteropeptidase
d. trypsin

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Which of the following is absorbed primarily in the ileum?

a. monosaccharide
b. dipeptides
c. bile salts
d. fat soluble vitamins

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Which of the following is true of carbohydrate digestion and absorption?

a. Digestion begins in the stomach by pepsin
b. Luminal digestion is carried out by amylase
c. Absorption occurs mainly in distal small intestine
d. Absorbed monosaccharies are immediately absorbed by intestinal cells

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Which of the following water soluble vitamins will be absorbed by facilitated transport?

a. ascorbic acid
b. folic acid
c. pantotheic acid
d. thiamine

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Which of the following carbohydrates is absorbed most rapidly?

a. trehalose
b. lactose
c. galactose
d. arabinose

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Lipid digestion and absorption includes

a. Emulsification of large lipids into small droplets by bile salts
b. Complete digestion by lingual and gastric lipase
c. Bile salts in micelles carrying fatty acids across the intestinal cell membrane
d. Absorbed short chain fatty acids entering mainly lymphatic vessels

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Which of the following substances are primarily absorbed in the proximal small intestines?

a. Vitamin B12 and glucose
b. glucose and fatty acids
c. fatty acids and bile acids
d. bile acids and vitamin B12

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Maltose is digested into

a. glucose + synthetase
b. glucose + xylose
c. galactose + fructose
d. glucose + glucose

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Digestive enzymes necessary for protein digestion include

a. pepsin, amylase, lipase
b. pepsin, carboxypeptidase, amylase
c. pepsin, carboxypeptidase, elastase
d. carboxypeptidase, elastase, lipase

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Dietary saturated fat content is recommended to be less than

a. 10%
b. 20%
c. 30%
d. 40%

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The total caloric requirement of a 56kg male with normal BMI admitted for mild infection is

a. 1420
b. 1680
c. 1850
d. 2110

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The caloric content of 30 grams of carbohydrates is

a. 120
b. 150
c. 210
d. 270

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The caloric content of 40g of alcohol is

a. 210
b. 255
c. 280
d. 300

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Which food group occupies the apex of the food pyramid

a. milk, coconut, cheese group
b. cereals, pasta, bread group
c. fats, oil, sweets group
d. meat, poultry, fish group

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The protein requirement of a sedentary 60kg male with normal BMI is approximately

a. 45
b. 60
c. 75
d. 90

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Increased health risk in women is associated with a “cut off” waist measurement greater than

a. 28
b. 32
c. 35
d. 40

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Which of the following is a saturated oil?

a. canola
b. olive
c. coconut
d. peanut

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According to food pyramids, how many daily servings of cereals, pasta, bread group is advised?

a. 2-3
b. 3-5
c. 2-4
d. 6-11

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How many calories does 1/2 cup of rice and 8oz coke have?

a. 100
b. 200
c. 300
d. 400

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Desirable Body Weight of a man 5 feet 6 inches tall is (using Nutritionist Dietician Association of the Philippines formula)

a. 124
b. 136
c. 148
d. 153

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Which of the following secretions is almost exclusively under neuronic control?

a. gastric secretion
b. intestinal secretion
c. pancreatic secretion
d. salivary secretion

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Gastric parietal cells secrete

a. gastric intrinsic factor
b. gastrin
c. somatostatin
d. CCK

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Bile acid uptake by hepatocytes is dependent on

a. Ca
b. Na
c. K
d. Iron

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Which phase of gastric secretion produces the greatest volume of acid?

a. cephalic
b. gastric
c. intestinal
d. each phase has equal distribution

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The enzyme responsible for the active secretion
of H+ by the parietal cells

a. Na+-K+ ATPase
b. H+-K+ ATPase
c. Adenylate cyclase
d. Carbonic anhydrase

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Histamine is released by which type of cell?

a. G cells
b. Parietal cells
c. ECL cells
d. Chief cells

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The primary active process in the concentration of
bile in the gallbladder is:

a. the active transport of Na+
b. the active transport of Cl-
c. the active transport of HCO3-
d. increased hydrostatic pressure in the cell

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True of salivary secretion except

a. saliva is always hypotonic to plasma
b. [K+] is always much greater than plasma
c. [HCO3-] is greater at all flow rates
d. [Na+] and [Cl-] are always much less
than plasma

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Which of the following hormones tends to
stimulate pancreatic secretion that is rich in
bicarbonate?

a. somatostatin
b. secretin
c. CCK
d. gastrin

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Which of the following will cause the gallbladder to
contract?

a. gastrin
b. secretin
c. somatostatin
d. CCK

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The hormone involved in the inhibition of gastric
juice secretion during the cephalic phase is

a. CCK
b. VIP
c. Secretin
d. Somatostatin

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In a person with very much reduced parietal cell
mass one can expect

a. gastrinemia (increased gastrin in the blood)
b. more incidence of overgrowth of intestinal microflora
c. BOTA
d. NOTA

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Vagal stimulation could affect gastric acid
secretion by

a. directly exciting parietal cells
b. increasing the release of gastrin from G cells
c. BOTA
d. NOTA

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The proteolytic enzyme secreted by the pancreas
except

a. trypsin
b. chmotrypsin
c. phospholipase A
d. carboxypeptidase

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The hormone which can inhibit both pancreatic
and gastric juice secretions is:

a. CCK
b. secretin
c. somatostatin
d. VIP

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Trypsinogen is activated by:

a. H+ ions and pepsin
b. enterokinase and trypsin
c. chymotrypsin and amylase
d. pepsin and trypsin

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Bile pigment responsible for the yellow gold color
of normal feces

a. urobilin
b. urobilinogen
c. stercobilin
d. bilirubinglucoronide

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The amount of bile secretion by the liver can be
affected by

a. vagal stimulation and secretin
b. secretin and CCK
c. CCK and volume of blood flow in liver
d. AOTA

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Loss of bile from a draining cutaneous fistula (an
abnormal connection between two areas, in this case, between the common bile duct and the skin) would result in all of the following, EXCEPT:

a. an increased rate of bile acid synthesis
b. maldigestion and malabsorption of fats.
c. jaundice (yellow discoloration of the skin due to bilirubin)
d. decrease body bile acid pool

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Severe diarrhea results in:

a. hypokalemia
b. acidosis
c. both
d. neither

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When chyme enters the duodenum it may cause

a. decreased gastric juice secretion
b. increased pancreatic juice secretion
c. increased bile secretion
d. AOTA

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Feeding after vagotomy is still expected to initiate

a. increase in secretion of saliva
b. increase in secretion of gastric juice
c. Increase in secretion of pancreatic juice
d. increase in secretion of bile

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The secretory ducts of the salivary glands modify
primary secretion by:

a. increasing the volume to make it hypotonic
b. extracting Na+ and Cl-
c. extracting K
d. extracting HCO3-

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That the formation of GIT exocrine secretion does
not consist merely of a passive filtration process is
suggested by

a. secretion continues
b. secretion continues some time after ligation of an artery
c. both
d. neither

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The finding that there is more Na+ and Cl- in the
beginning of the intercalated ducts than the exocrine duct of a salivary gland suggests

a. secretory function of the tubular segment
b. reabsorption function of the tubular segment
c. secretory function of acinar cells
d. reabsorption function of acinar cells

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A decrease of the parietal cell mass of the
stomach is expected to cause

a, decrease of proteolytic activity of gastric juice

b. decrease efficiency of Vit B 12 absorption
c. both
d. neither

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A proteolytic enzyme secreted by the gastric
glands is:

a. chymotrypsin
b. pepsin
c. trypsin
d. aminpeptidase

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Which of the following stimulates secretion during
the 3 phases of gastric acid secretion?

a. gastrin
b. secretin
c. CCK
d. VIP

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Placing of distasteful food in the mouth is
expected to cause

a. increased salivary secretion
b. decreased gastric juice secretion
c. decreased pancreatic juice
d. AOTA

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In a patient with complete obstruction of the
common bile duct one can expect all the following except

a. increase fecal fat in stool
b. yellow discoloration of stool
c. increase urobilinogen in urine
d. increase bilirubin of his blood

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In a patient with complete obstruction of the common bile duct, you request for liver function test. You would expect results of

a. increase in direct indirect bilirubin
b. increase alkaline phosphatase
c. elevated AST
d. elevated ALT

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In the first few hours of abdominal pain a patient
with acute pancreatitis will have

a. increased fat in stool
b. high serum amylase
c. high salivary amylase
d. high serum lipase

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In a patient with chronic liver disease you may
expect the following, EXCEPT

a. low serum albumin
b. deranged prothrombin time
c. deranged factor VIII
d. low serum globulin

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Increase intestinal secretion may result from

a. the action of gastrin
b. The action of VIP
c. distention of segment
d. AOTA

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The enzyme in the liver which transfers bilirubin into a water soluble compound is

a. enterokinase
b. alkaline phosphatase
c. glucoronyl transferase
d. glutamine oxaloacetate transaminase

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What is the difference between GI smooth
muscle and skeletal muscle?

a. GI smooth muscles contract slowly but more efficiently compared to skeletal muscle
b. GI smooth muscles contract slowly but less efficiently compared to skeletal muscle
c. GI smooth muscles contract rapidly but more efficiently compared to skeletal muscle
d. GI smooth muscles contract rapidly but less efficiently compared to skeletal muscle

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What segment of the GIT has the lowest
number of slow waves?

a. Stomach
b. Duodenum
c. Ileum
d. Colon

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The vomiting center is in the:

a. Parietal lobe
b. Frontal lobe
c. Cerebellum
d. Medulla

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Fat in the duodenum reduces gastric
emptying time by releasing which hormones?

a. Gastrin
b. Nitric oxide
c. Secretin
d. CCK
e. C and D
f. A and B

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Which part of the GIT is there the slowest
emptying of contents?

a. Esophagus
b. Stomach
c. Small intestine
d. Colon

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True of the sphincter of Oddi:

a. Relaxed most of the time
b. Prevents entry of duodenal contents into the pancreatic duct
c. Pressure is lower than in the pancreatic duct
d. Relaxed mainly by somatostatin after a meal

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LES pressure is deceased by:

a. Bombesin
b. Gastrin
c. Motilin
d. Secretin

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MMC is most probably mediated by:

a. Bombasin
b. Secretin
c. VIP
d. Motilin

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Stimulation of mass movements after
ingestion of a meal is called

a. Restosphincteric reflex
b. Enterogastric reflex
c. Gastrocolic reflex
d. Ileal break

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Swallowing results to:

a. Contraction of the UES
b. Absence of peristalsis in the esophagus
c. Relaxation of fundus of stomach
d. Contraction of LES

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Which of the following sphincters is under
voluntary control?

a. Upper esophageal sphincter
b. Pyloric sphincter
c. Ileocecal valve
d. Internal anal sphincter

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Slow undulating changes in resting potential; secondary to undulation of membrane potential

a. MMC
b. Fed pattern
c. Slow waves
d. Spike potentials

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Which of the following isocaloric food will empty first in the stomach

a. High fat solid product
b. High fat liquid product
c. High protein solid
d. High protein liquid

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Gastric emptying is stimulated by

a. Tryptophan
b. Gastrin
c. Duodenal acidity
d. High gastric lipid

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Which is true regarding the UES

a. Open at rest
b. Lower basal pressure than the LES
c. Relaxed during sleep
d. NOTA

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Relaxation of LES during swallowing is most likely due to:

a. Bombesin
b. Gastrin
c. Motilin
d. Nitric oxide

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DBW of 5’4” female using NDAP formula

a. 122 lbs
b. 132 lbs
c. 142 lbs
d. 152 lbs

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Daily protein requirement for 65kg male

a. 55
b. 60
c. 65
d. 70

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Caloric content of 20g of alcohol

a. 130 kCal
b. 140 kCal
c. 150 kCal
d. 160 kCal

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Cut-off of waist circumference in men:

a. 70 cm
b. 80 cm
c. 90 cm
d. 100 cm

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Which carbohydrate is absorbed most
rapidly?

a. Glucose
b. Amylose
c. Arabinose
d. Galactose

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Fiber in diet is mostly

a. Amylopectin
b. Glycogen
c. Cellulose
d. Starch

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The following use Na+ mechanism except

a. Amino acids
b. Iron
c. Glucose
d. Folic acid

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Luminal absorption is not necessary for digestion of

a. Oligopeptides
b. Glycoprotein
c. Amylase
d. Sucrose

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Excess iron found at the intestinal epithelial cells as

a. Ferritin
b. Transferrin
c. Mobilferrin
d. hemoCh

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Iron absorption is increased by:

a. Ascorbic acid
b. Herbal tea
c. Sexual activity
d. Iron loading

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Lipid digestion starts at the:

a. Mouth
b. Esophagus
c. Stomach
d. Small intestines

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Phospholipase and procarboxylase are activated by:

a. Enterokinase
b. Ribonuclease
c. Trypsin
d. HCl

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Which of the following is true regarding lipid digestion and absorption?

A. Complete digestion by lingual and
gastric lipase
B. Emulsification of large lipids into small
droplets by bile salts
C. Bile salts in micelles carrying fatty acids
across intestinal cell membrane
D. Absorbed salts carrying fatty acids
entering mainly lymphatic vessels

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Absorbed in proximal intestine

a. Bile acid/vit b12
b. Fatty acid/galactose
c. Galactose/bile acid
d. Galactose/vit b12

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Omeprazole, a proton pump inhibitor, inhibits acid secretion by:

a. H+K+ ATPase
b. Binding M3 muscarinic receptor
c. Blocking gastrin receptor
d. Blocking H2 histamine receptor

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Diagnostic tests for the liver may measure:

a. CCK
b. ALT
c. Alkaline phosphatase
d. Amylase
e, B and C
f. A and B

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There is increased production of _________ when hepatocytes are damaged.

a. CCK
b. ALT
c. Alkaline phosphatase
d. Amylase

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Highest optimal density

a. BAPNA + pepsin pH 2.0
b. BAPNA + pepsin pH 7.0
c. BAPNA + pepsin pH 9.0
d. Water + pepsin

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Complete obstruction of the common bile duct will
maximally affect the digestion of which of the
following?

a. Proteins
b. Carbohydrates
c. Fats
d. All of the above

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Glucose molecules are absorbed through the apical membrane of enterocytes by:

a. Passive diffusion
b. Facilitated diffusion
c. Secondary active transport
d. Primary active transport

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Absorption of water is achieved by:

A. endocytosis
B. exocytosis
C. secondary active transport
D. osmosis

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Glucose molecules are pass through the basolateral membrane of enterocytes by:

a. Passive diffusion
b. Facilitated diffusion
c. Secondary active transport
d. Primary active transport

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Complete resection of the stomach will have the most deleterious effect on the absorption which vitamin?

A. C
B. D
C. B12
D. B6

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Which of the following statements best describe fat
digestion and absorption?

a. Lingual lipase is responsible for the majority of fat luminal digestion
b. Triglycerides and cholesterol esters diffuse across the luminal membrane of the enterocyte
c. Bile acids emulsify lipids and increase the surface area for digestion
d. Chylomicrons are transported directly to the portal vein

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Which of the following statements most accurately
describe protein digestion and absorption?

a. Chymotrypsinogen is activated to chymotripsin by enterokinase
b. Dipeptides, tripeptides and amino acids are absorbable forms of protein digestion
c. The optimum pH for pepsinogen activation is between 7 and 9
d. Amino acids are transported from the enterocytes into the bloodstream via secondary active transport

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Resection of the ileum results to malabsorption of which of the following?

a. proteins
b. fats
c. carbohydrates
d. vitamin B6

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Lactose intolerance represents inadequate _________ digestion of carbohydrates?

a. luminal
b. membrane
c. both a and b
d. none of the above

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Which of the following statements most accurately describes carbohydrate digestion and absorption?

a. Luminal digestion is performed by lactase.
b. Membrane digestion is performed by pancreatic amylase.
c. Monosaccharides and disaccharides can be absorbed.
d. Glucose is absorbed via secondary active transport.

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Which of the following is TRUE regarding lipid digestion and absorption?

a. Complete digestion by lingual and gastric lipase.
b. Emulsification of large lipids into small droplets by bile salts.
c. Bile salts in micelles carrying fatty acids across the intestinal membrane.
d. Absorbed short chain fatty acids enter the portal vein
e. AOTA
f. NOTA

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Which of the following substances are primarily absorbed in the proximal small intestines?

A. Fatty acids and bile acids
B. Bile acids and Vitamin B12
C. Vitamin B12 and Galactose
D. Galactose and Fatty acids

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Maltose is digested into:

A. Glucose + Arabinose
B. Glucose + Galactose
C. Glucose + Fructose
D. Glucose + Glucose

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Which of the following pancreatic enzymes for digestion is secreted in its active form ?

A. Trypsinogen
B. Pepsinogen
C. Lipase
D. Elastase

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The main digestive process is called

A. Acidification
B. Oxidation
C. Reduction
D. Hydrolysis

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Which form of carbohydrate serves as the substrate for carbohydrate membrane digestion?

a. monosaccharides
b. disaccharides
c. polysaccharides
d. AOTA

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Which of the following statements is/are true regarding the absorption of monosaccharides?

a. it requires ATP/energy
b. glucose absorption depends on endocytosis
c. glucose absorption depends on diffusion
d. does not require transport proteins

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Which of the following statements are true regarding the digestion of disaccharides?

A. Sucrose is broken down into fructose and galactose
B. Lactose is broken down into 2 molecules of galactose
C. Maltose is broken down into two molecules of glucose
D. Alpha-dextrinase acts upon sucrose oligomers

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Which of the following statements is/are true regarding the absorption of monosaccharides?

A. SGLT1 transporter moves glucose across the basolateral membrane
B. SGLT 1 transporter moves galactose across the basolateral memebrane
C. GLUT5 transporter moves fructose across the luminal membrane
D. GLUT2 tarnsporter moves glucose across the luminal membrane

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This enzyme is responsible for membrane digestion of proteins

a. peptidase
b. pepsin
c. trypsin
d. chymotrypsin

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Which of the following represents the product of peptidase action in protein digestion?

a. Polypeptides
b. Proteases
c. Peptones
d. Amino Acids

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Which monosaccharide is absorbed across the luminal membrane using facilitated diffusion?

A. Glucose
B. Galactose
C. Fructose
D. Sucrose

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Which of the following statements is/are true regarding fat digestion and absorption?

A. Most of its luminal digestion happens in the stomach
B. Most of its luminal digestion happens in the small intestine
C. Pancreatic secretory products act to emulsify large fat droplets
D. Glycerol and fatty acids cross the luminal membrane via endocytosis.

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Which of the following statements is/are true regarding the absorption of iron?

a. Absorption occurs at the stomach.
b. Ferric form of iron is most readily absorb.
c. Absorption is increased by ascorbic
acid.
d. Absorption is increased by wheat and cereals.

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Procarboxypeptidase and trypsinogen are both activated by:

a. pepsin
b. trypsin
c. ribonuclease
d. enterokinase

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Which carrier protein is responsible for transporting fructose from lumen into enterocytes?

a. GLUT-1
b. GLUT-2
c. GLUT-4
d. GLUT-5

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Which of the following secretions is almost exclusively under neural control?

a. Gastric secretions
b. Intestinal secretions
c. Pancreatic secretions
d. Salivary secretions

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Which of the following is the primary physiologic control for salivary secretion?

a. sympathetic nervous system
b. parasympathetic nervous system
c. predominantly hormonal
d. combination

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Which of the following do gastric parietal cells secrete?

a. intrinsic factor
b. gastrin
c. somatostatin
d. Cholecystokinin (CCK)

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Which of the following ions is bile acid uptake by
hepatocytes dependent on?

A. Calcium
B. Sodium
C. Potassium
D. Iron

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Which phase of the gastric secretion produces the
greatest volume of acid?

A. Cephalic
B. Gastric
C. Intestinal
D. Each phase has equal contribution

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The enzyme responsible for active secretion of
hydrogen ions by the parietal cell

A. Na+-K+ ATPase
B. H+-K+ ATPase
C. Adenylate cyclase
D. Carbonic anhydrase

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Which type of cell secretes histamine?

A. G cells
B. Parietal cells
C. ECL cells (enterochromaffin- like cells)
D. Chief cells

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Which of the following proteins is absent in
saliva?

A. Lingual lipase
B. Amylase
C. Mucin
D. Intrinsic factor

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Which of the following is the primary active
process involved in the concentration of bile in
the gallbladder?

A. Active transport of Na+
B. Active transport of Cl-
C. Active transport of HCO3-
D. Increased hydrostatic pressure in the cell

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Which of the following would account for the
hypotonic content of saliva in the main ducts?

A. Absorption of Na+
B. Secretion of Na+
C. Secretion of Cl-
D. Absorption of HCO3-

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Which of the following hormones tend to
stimulate pancreatic secretion that is rich in
bicarbonate?

A. Somatostatin
B. Secretin
C. CCK
D. Gastrin

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Which of the following is NOT an inhibitor of
gastric acid secretion?

A. Acid
B. Somatostatin
C. Food
D. Acetylcholine

Which of the following cells synthesize and
secrete the protease precursor pepsinogen?

A. Chief cell
B. Parietal cell
C. G cell
D. Enterochromaffin Like Cell

Which of the following statements about intrinsic
factor is TRUE?

A. It is the only gastric secretion that is essential for health
B. It is secreted by chief cells
C. It forms a complex with albumin
D. Lack of it causes megaloblastic anemia

Which of the following hormones causes the
gallbladder to contract?

A. Gastrin
B. Secretin
C. Somatostatin
D. CCK

The interaction of histamine with its receptor
in the parietal cell results in:

A. an increase in intracellular sodium concentration
B. an increase in intracellular cAMP production
C. an increase in intracellular cGMP production
D. an increase in intracellular Calcium concentration

The hormone involved in the inhibition of gastric juice secretion during the cephalic phase is

A. CCK
B. Vasoactive Intestinal Peptide
C. Secretin
D. Somatostatin

Vagal stimulation could affect gastric acid secretion by

A. directly exciting the parietal cells
B. increasing the release of gastrin from the G
cells
C. both mechanisms
D. neither

The hormone which can inhibit both pancreatic and gastric juice secretions is

A. CCK
B. Secretin
C. Somatostatin
D. VIP

Trypsinogen is activated by:

A. Hydrogen ions and pepsin
B. Enterokinase and trypsin
C. Chymotrypsin and amylase
D. Alkaline medium partly regulates it

Which of the following statements is true
statements regarding regulation of gastrin
release?

A. Increase in pH inhibits G cells
B. Fats in a meal buffers the proton
C. Proteins in a meal buffers the proton
D. Alkaline medium partly regulates it

Loss of bile from a draining cutaneous fistula (an
abnormal connection between two areas, in this
case, between the common bile duct and the
skin) would results in all of the following except:

A. an increased rate of bile acid synthesis
B. maldigestion and malabsorption of fats
C. jaundice (yellow discoloration of skin due to bilirubin)
D. decreased body bile acid pool

When chyme enters the duodenum, it may cause:

A. decreased gastric juice secretion
B. increased pancreatic juice secretion
C. increased bile secretion
D. all of the above

Which of the following phases of pancreatic
secretion is not significant in humans?

A. Cephalic phase
B. Gastric phase
C. Intestinal phase
D. All are important

The finding that there is more Na+ and Cl- in the
beginning of the intercalated ducts than the
excretory ducts of a salivary gland suggests:

A. Secretory function of the tubular system
B. Reabsorptive function of the tubular
system
C. Secretory function of the acinar cells
D. Reabsorptive function of the acinar cells

Which of the following GI segment has the
longest transit time?

A. Esophagus
B. Stomach
C. Small Intestines
D. Colon

Which of the following NTs in the enteric nervous
system (ENS) is excitable to smooth muscle cells?

A. Nitric oxide (NO)
B. Vasoactive intestinal peptide (VIP)
C. Acetylcholine
D. ATPase

Which of the following NTs causes pyloric
sphincter relaxation?

A. VIP
B. Gastrin
C. GIP
D. Secretin

Duodenal activity causes inhibition of gastric
emptying by releasing hormone:

A. GTP
B. CCK
C. Secretin
D. Somatostatin

Which of the following organs has the lowest slow
wave frequency?

A. Esophagus
B. Stomach
C. Duodenum
D. Colon

Parasympathetic supply to the descending colon
is provided by:

A. Pelvic nerve
B. Superior hypogastric plexus
C. Inferior mesenteric plexus
D. Vagus nerve

The emptying function of the stomach is
performed mainly by:

A. Fundus
B. Distal body
C. Antrum
D. Pylorus

Which of the following is an example of unitary
type of smooth muscle

A. Iris muscle of the eye
B. Ciliary muscle of the eye
C. Piloerector muscle
D. Gastric smooth muscle

Successful bowel movement is made possible by
all of the following physiological responses
EXCEPT:

A. Relaxation of the internal anal sphincter
B. Relaxation of the external anal sphincter
C. Contraction of longitudinal rectal muscle
D. Decrease in anorectal angle

Which of the following is characteristic of
Migratory motor complex (MMC)?

A. It is regulated by tachykinins
B. It starts either in the esophagus or colon
C. It is terminated by feeding
D. It consists of segmentation contractions only

Which of the following organs have oblique
muscle?

A. Gallbladder
B. Spleen
C. Stomach
D. Colon

Reverse peristalsis normally occurs during:

A. Migratory motor complex
B. Swallowing
C. Vomiting
D. Chewing

Which of the following sphincters is under
voluntary control?

A. Sphincter of Oddi
B. Pyloric sphincter
C. Upper esophageal sphincter
D. Internal anal sphincter

Stimulation of mass movements after ingestion of
a meal is called:

A. Ileal break
B. Rectoanal reflex
C. Enterogastric reflex
D. Gastrocolic reflex

Which of the following isocaloric meals will be
emptied third by the stomach?

a. High protein solid meal
b. High protein liquid meal
c. High fat solid diet
d. High fat liquid meal

Which of the following reflexes stimulate GI
motility?

a. Intestino-intestinal
b. Gastroileal
c. Enterogastric
d. Gastrogastric

Which of the following motor activities are partly
under voluntary control?

a. Colonic mass movements
b. Small intestinal motility
c. Gallbladder emptying
d. Swallowing

Which of the following drugs will be most effective
in the treatment of Gastroesophageal Reflex Disease (GERD)?

a. Anticholinergics
b. Barbiturates
c. Proton pump inhibitor
d. Calcium blockers

A patient with peptic ulcer disease develops
gastric outlet obstruction. Which physical exam finding is associated with gastric outlet obstruction?

a. Borborygmi
b. Grey Turner’s sign
c. Succussion splash
d. Shifting dullness

Which of the following physical examination
findings is most likely to be abnormal?

a. Visible pulsations at the abdominal area
b. Protuberant abdomen
c. Palpable spleen
d. Palpable sigmoid colon

Which sign of acute appendicitis is positive when
patient feels RLQ pain with internal rotation of the
flexed right hip?

a. Rovsing’s
b. Markle
c. Obturator
d. Psoas

Which of the following sounds produced by
percussion is CORRECTLY paired with the organ producing the sound?

a. Stomach: Bruit
b. Intestines: Resonance
c. Lungs: Tympany
d. Liver: Dullness

An example of monounsaturated fat is

a. Sunflower oil
b. Palm oil
c. Sesame oil
d. Canola oil

Dietary saturated fat content is recommended to
less than

a. 10%
b. 20%
c. 30%
d. 40%

How many calories in a 16 oz. cola?

a. 100
b. 200
c. 300
d. 400

8oz. of coke is 100 calories. Multiply by 2

Desirable body weight of a man 5 feet 8 inches tall
(using Nutritionist-Dietitians Association of the
Philippines formula)?

a. 124
b. 134
c. 144
d. 154

Explanation: DBW (male) = 112 +/- (4 x # of inches
in excess/short of 5 feet) = 112 + (4 x 8) = 112 + 32 = 144

Nutritious diet suggests that trans fat of any food
should be:

A. 0%
B. 10%
C. 20%
D. 30%

The drink that contains 45 grams of alcohol and
15 grams of sugar has a caloric content of

a. 225
b. 275
c. 325
d. 375

1 gram of alcohol contains 7 calories
while 1 gram of sugar contains 4 calories.

Therefore,
caloric content = (7 x 45) + (4 x 15) = 375.

Murphy’s sign is associated with:

A. Acute appendicitis
B. Acute diverticulitis
C. Acute pancreatitis
D. Acute cholescystitis
E. Gastric outlet obstruction

Grey Turner’s sign is associated with:

A. Acute appendicitis
B. Acute diverticulitis
C. Acute pancreatitis
D. Acute cholescystitis
E. Gastric outlet obstruction

Rovsing’s sign is associated with:

A. Acute appendicitis
B. Acute diverticulitis
C. Acute pancreatitis
D. Acute cholescystitis
E. Gastric outlet obstruction

Taste sensation:

A. increased with age
B. decreased with age
C. no change with aging

Number of gastric parietal cells:

A. increased with age
B. decreased with age
C. no change with aging

Increase with age may occur as compensation for the fact that acid secretion decreases with age

Secondary peristalsis in the esophagus:

A. increased with age
B. decreased with age
C. no change with aging

Small intestine immune function:

A. increased with age
B. decreased with age
C. no change with aging

Pancreas:

A. increased with age
B. decreased with age
C. no change with aging

Small intestine villus height:

A. increased with age
B. decreased with age
C. no change with aging

Perception of anorectal distention:

A. increased with age
B. decreased with age
C. no change with aging

Lipofucscin in liver:

A. increased with age
B. decreased with age
C. no change with aging

Hepatic blood flow:

A. increased with age
B. decreased with age
C. no change with aging

Gallbladder stones:

A. increased with age
B. decreased with age
C. no change with aging

Compute the DBW of a female whose height is 5ft

5in using the Broca’s method.

5ft 5in = 65 in x 2.54 = 165.1 = 165 cm
165 - 100 = 65 - 6.5 = 58.5 kg

Answer: 58.5 kg

Compute the DBW of a female whose height is 5ft

4in using the Nutritionist-Dietitian Associations of the Philippines Formula

5ft female = 106
5ft 4in = 106 + 4(4) = 122 lbs

Answer: 122 lbs

Compute the future weight of a woman whose

total energy allowance is 1500kcal/day but consumes 1750kcal/day daily for 1 year. Present weight is 117lbs.

1750-1500 = 250kcal/day x7 = 1750kcal/week = 1/2lb/wk

Future weight=117+(52x1/2lb/week) = 117+26=143lbs

Answer: 143 lbs

Which of the following phases is voluntary?

A. Oral
B. Pharyngeal
C. Esophageal
D. Gastric

Which of the following statements describe the
esophageal phase of swallowing?

A. It is voluntary
B. Food is aided by gravity
C. It is inhibited by anti-cholinergic drugs
D. It lasts for about 20 seconds

Esophageal peristalsis is associated with gastric

A. receptive relaxation
B, retropulsion
C. enterogastric reflex
D. distension

What disease of the esophagus happens when
there is failure of LES to relax because of
abnormalities in the myenteric plexus of the distal
esophagus?

A. Hirchsprung’s disease
B. Achalasia
C. Dyspepsia
D. Cystic fibrosis

Constriction of mixing waves begin in gastric
_______.

A. fundus
B. cardia
C. midbody
D. antrum

Normally, food in the GIT stays longest in the

A. Esophagus
B. Stomach
C. Small intestine
D. Colon

Which of the following stimulations hyperpolarize smooth muscles of esophagus?

A. sympathetic
B. parasympathetic
C. acetycholine
D. distention

Which of the ff. factors stimulates intestinal
motility but inhibits gastric emptying?

A. CCK
B. gastrin
C. secretin
D. serotonin

What is the most common cause of gastroesophageal reflux?

A. Hypotensive LES pressure
B. Transient LES relaxation
C. Short LES
D. Hiatal hernia

Which of these factors lower LES pressure?

A. Antacid
B. Bouibellin
C. Calcium blocker
D. Enkephalin

Which of the following sphincters are voluntary?

A. external anal sphincter and pyloric
B. upper esophageal sphincter and pyloric
C. ileal sphincter and pyloric
D. external anal sphinter and upper
esophageal sphincter

Mixing contractions of the colon are

A. Tonus
B. Haustrations
C. Retropulsion
D. Retching

Where is Murphy’s sign elicited?

A. RUQ
B. RLQ
C. LUQ
D. LLQ

The liver can be percussed at the

A. Right anterior axillary line
B. Right midclavicular line
C. Vertebral line
D. Midsternal line

Which factor prevents trypsin activation in the
pancreas?

A. Synthesis of protease inhibitor serine
protease inhibitor kazal type 1 (SPINK 1)
B. Packaging of proteases as active enzymes
C. High Ca2+ concentration in the pancreas
D. Activation of trypsinogen in the stomach

Which of the following fats is least healthy?

A. sunflower oil
B. corn oil
C. coconut oil
D. canola oil

Pancreatic secretions produce enzymes that
digest

A. Neutral fat
B. Cellulose
C. Tripeptides
D. Toxins

Which of the following vitamins is best absorbed
by the ileum?

A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin D

Which of the following statements accurately
describes carbohydrate digestion and absorption?

A. Monosaccharides and disaccharides are
absorbed readily.
B. Luminal digestion is performed by lactase.
C. Glucose is absorbed via secondary active
transport.
D. Membrane digestion is performed by
pancreatic lipase.

The complete retraction of ileum will completely
affect the absorption of _____.

A. carbohydrate
B. protein
C. fats
D. water-soluble vitamins

Digestive enzymes responsible for protein
digestion

A. Lactase, -dextriase, pepsin
B. -dextriase, pepsin, carboxypeptidase
C. Pepsin, carboxypeptidase, trypsin
D. Carboxypeptidase, trypsin, lactase

Which of the following is most absorbable in the
proximal small intestine?

A. galactose and fatty acids
B. bile acids and fatty acids
C. vitamin B12 and bile acids
D. fatty acids and vitamin B12

Galactose molecule is absorbed through apical
membrane of enterocytes by:

A. passive diffusion
B. facilitated diffusion
C. secondary active transport
D. primary active transport

The major foodstuffs in GIT are processed by:

A. Conjugation
B. Hydrolysis
C. Condensation
D. Electrophilic addition

Carbohydrate digestion begins in the:

A. mouth
B. esophagus
C. stomach
D. small intestine

What substance increases the rate of iron
absorption?

A. cereals
B. citrate
C. non-herbal teas
D. phytate

Which of the following is absorbed through a H+
dependent mechanism?

A. Galactose
B. Fatty Acids
C. Tripeptide
D. Amino Acids

What is the common monosaccharide that can
be derived from maltose, sucrose, lactose and
maltotriose?

A. Galactose
B. Fructose
C. Glucose
D. NOTA

Which of the following pancreatic enzymes is
secreted in active form?

A. elastase
B. lipase
C. pepsin
D. trypsin

Divalent cations, like Ca2+ and Fe3+ are best
absorbed in the:

A. duodenum
B. jejunum
C. ileum
D. colon

Milk sugar is broken down into:

A. Glucose and Fructose
B. Glucose and Glucose
C. Maltose and Galactose
D. Glucose and Galactose

Chymotrypsinogen is activated by

A. enterokinase
B. trypsin
C. pepsin
D. HCl

Absorption of these vitamins is dependent on
lipid absorption EXCEPT:

A. vitamin A
B. vitamin B
C. vitamin D
D. vitamin E

Which characterizes primary salivary secretion?

A. Hypotonic to plasma
B. Isotonic to plasma
C. K+ less than plasma
D. HCO3- less than plasma

What is the characteristic of the salivary ductular
system?

A. Absolutely permeable to H2O
B. Na is absorbed
C. HCO3 is absorbed
D. Final solution is isotonic

Salivary glands are mainly controlled by

A. Sympathetic stimulation
B. Parasympathetic stimulation
C. Both sympathetic and parasympathetic stimulation
D. Hormonal stimulation

What is the common luminal secretion in the
cardia, antrum and pylorus of the stomach?

A. H+
B. IF
C. Pepsinogen
D. Mucus
E. NOTA

Which region/s in the stomach has H+ and
pepsinogen as its most luminal secretion?

A. cardia
B. fundus
C. antrum
D. pylorus

Primary secretion of the stomach that denatures
proteins and has antimicrobial properties

A. pepsinogen
B. intrinsic factor
C. HCl
D. somatostatin

Which of the following is true about gastric
secretion?

A. Higher flow rate, Higher [H+]
B. Higher flow rate, Higher [Na+]
C. [K+] is lower in plasma
D. HCO3- is the major anion

What is the basal rate of gastric secretion?

A. 1-5 meq/ min
B. 5-30 meq/ min
C. 6-40 meq/ min
D. NOTA

Which of these is a characteristic of secretory
parietal cells?

A. increase in vesicles
B. tubulovesicle fusing into secretory canaliculi
C. ovoid shape cell
D. pyramidal shaped nucleus

Which of the following enzymes actively contributes to the secretion of gastric acid?

A. H-K-ATPase
B. Na-K ATPase
C. Carbonic anhydrase
D. HCO3-Cl-ATPase

Which of the following is the right combination of
stomach acid agonists?

A. Acetylcholine-neurocrine
B. Gastrin-Paracrine
C. Histamine-Endocrine
D. Somatostatin-Paracrine

Strongest agonist for Hydrogen secretion in
the stomach

A. Gastrin
B. CCK
C. Histamine
D. food

Which is important for the trophic effect to the
ECL cells?

A. Histamine
B. Gastrin
C. Acetylcholine
D. Intracellular Calcium

What directly inhibits gastric release?

A. Acid
B. Food
C. Somatostatin
D. VIP

What is true about pancreatic secretions?

A. It is isotonic to plasma at all secretion rates
B. [Na+] and [K+] are similar to plasma
C. HCO3- is less than in plasma
D. [Cl-] is greater in plasma

Which is an endopeptidase?

A. trypsin
B. carboxypeptidase
C. aminopeptidase
D. nuclease

Which of the following would most likely occur in
a patient with diarrhea that is not treated properly?

A. alkalosis
B. hyperkalemia
C. acidosis
D. hypernatremia

Which cell secretes histamine?

A. G cell
B. ECL
C. Parietal cell
D. Chief cell

Cholelithiasis:

A. increased with age
B. decreased with age
C. no change with aging

UES pressure:

A. increased with age
B. decreased with age
C. no change with aging

Presence of colonic diverticula:

A. increased with age
B. decreased with age
C. no change with aging

Gastric ulceration:

A. increased with age
B. decreased with age
C. no change with aging

The small intestinal modifications increase surface
area by how many times?

A. 200
B. 400
C. 600
D. 800

Formation of macromolecules from small molecules
occurs through?

A. Hydrolysis
B. Condensation
C. Sulfation
D. Amination

Pace maker cells in the intestines occur mainly in
the:

A. Colon
B. Ileum
C. Jejunum
D. Duodenum

Water absorption occurs through what process?

A. Primary active transport
B. Secondary active transport
C. Facilitated diffusion
D. Diffusion

Which of the following monosaccharides will be
absorbed last by enterocytes?

A. Xylose
B. Fructose
C. Glucose
D. Galactose

Fat is primarily absorbed in:

A. Rectum
B. Colon
C. Ileum
D. Proximal intestines

Iron absorption is inhibited by:

A. High gastric acidity
B. High protein meal
C. Ascorbic acid
D. Tea

Which of the following isocaloric meals will be
emptied first by the stomach?

A. High fat solid diet
B. High fat liquid diet
C. High protein solid diet
D. High protein liquid diet

Which of the following will increase gastric
emptying?

A. Tryptophan
B. Gastrin
C. Duodenal acidity
D. High gastric lipid

Which is TRUE about protein digestion and
absorption?

A. The main product of digestion is amino acids
B. Amino acids have only 1 transport protein
C. Some dipeptides can be absorbed directly
by enterocytes
D. Amino acids are more efficiently absorbed from
a mixture of amino acids than a mixture of
dipeptides
E. NOTA

Glucose absorption through the apical membrane of
enterocytes is through what transport mechanism?

A. Facilitated diffusion
B. Diffusion
C. Primary active transport
D. Secondary active transport

Pyloric sphincter is derived from?

A. Inner oblique muscles
B. Inner circular muscle
C. Outer oblique muscle
D. NOTA

The proximal compared to the distal stomach:

A. Exhibits receptive relaxation
B. Exhibits stronger peristalsis contraction
C. A and B
D. NOTA

The muscular layer of the GIT is primarily
responsible for?

A. Secretion
B. Absorption
C. Propulsion
D. Digestion

Which of the following contracts most frequently?

A. Stomach
B. Duodenum
C. Ileum
D. Colon

Which of the following is TRUE of slow waves?

A. Superimposed over spike potentials
B. Occur when resting membrane potential is -
60mV
C. Determine frequency of muscle
contraction
D. Slowest rate is in the duodenum

Which of the following is TRUE regarding the UES?

A. It is made up of smooth muscle
B. It has a higher basal pressure than LES
C. It relaxes earlier than the LES
D. It is open during rest

The storage function of the stomach is performed by the:

A. Fundus
B. Distal stomach
C. Antrum
D. Pylorus

Which of the following sphincters is under voluntary
control?

A. LES
B. Cardiac
C. EAS
D. Pyloric

Which is true of mastication?

A. Purely voluntary
B. Increase pleasure of eating
C. Required for carbohydrate digestion
D. Involves CN V and CN X

True of the salivary ductal system:

A. HCO3- absorbed
B. Na+ absorbed
C. Ducts are permeable to water
D. Isotonic to plasma

Which of the following gastric components binds to
Vit B12?

A. Intrinsic factor
B. Pepsin
C. Mucin
D. HCl

Primary driving force for ionic transport in salivary
acinar cells?

A. K channels
B. Na/K/2Cl symport
C. HCO3/Cl exchanger
D. Na-K ATPase

Which of the following is a common luminal
secretion of the cardia, antrum and pylorus?

A. HCl
B. Intrinsic factor
C. Mucus
D. Pepsinogen

Retching involved the following
responses EXCEPT:

A. Sympathetic stimulation
B. Stimulation of gastric motility
C. Relaxation of UES
D. Relaxation of LES
E. NOTA

True regarding peristalsis of the esophagus EXCEPT:

A. Decrease in LES pressure
B. Decrease in UES pressure
C. Increase in esophageal pressure
D. Increase in fundal pressure

Which region of the stomach has HCl and
pepsinogen as its main luminal secretion?

A. Cardia
B. Fundus
C. Antrum
D. Pylorus

Which of the following gastric cells produces a substance that inhibits acid secretion?

A. D cells
B. G cells
C. Chief cells
D. Parietal cells

Which of the following gastric cell secretions
denatures proteins and is involved in the 1st line of
defense against microbes?

A. Pepsinogen
B. HCl
C. Intrinsic factor
D. Gastrin

Rate of basal secretion of gastric acid:

A. 5-40 mEq/hr
B. 4-30 mEq/hr
C. 1-5 mEq/hr
D. 10-20 mEq/hr

Which is active in gastric acid secretion?

A. H-K ATPase
B. Na-Cl ATPase
C. Carbonic acid symport
D. Cl symport

Blockage of what membrane protein causes the
greatest acid reduction?

A. Muscarinic receptor
B. H2 receptor
C. CCK-B receptor
D. H-K ATPase

Which of the following is responsible for the trophic
effect of ECL cells?

A. Histamine
B. Acetylcholine
C. Gastrin
D. Intrinsic factor

Which of the following is true about pepsin
secretion?

A. Secreted in active form
B. 50% of protein digestion of meal
C. Activated at low pH
D. From parietal cell

Which of the following can cause an increase in
mucus secretions?

A. Acetylcholine
B. Food
C. Acid
D. Somatostatins

Which of the following does not stimulate increased
pancreatic secretion through increased intracellular
calcium?

A. ACh
B. Gastrin
C. CCK
D. Secretin

What is the primary innervation of salivation?

A. Sympathetic
B. Parasympathetic
C. Hormonal
D. A and B

What is the characteristic of primary salivary
secretion?

A. Lower K+ than plasma
B. Lower bicarbonate than plasma
C. Isotonic to plasma
D. Hypotonic to plasma

What is the most potent stimulant for gall bladder
contraction?

A. ACh
B. CCK
C. Gastrin
D. Intrinsic factor

Which of the following would most likely occur in a
patient with diarrhea that is not treated properly?

A. Hypokalemia and alkalosis
B. Hyperkalemia and acidosis
C. Hypokalemia and hyponatremia
D. Acidosis and hypokalemia

Which of the following are primary bile acids?

A. Cholic and chenodeoxycholic
B. Lithocholic and cholic
C. Cholic and deoxycholic
D. Lithocholic and chenodeoxycholic

Which is a specific indicator of liver injury?

A. ALT
B. AST
C. Alkaline phosphatase
D. AOTA
E. A and C
F. A and B

Which among the liver function tests is found in the
canalicular domain and is abnormal in conditions
with obstruction to bile flow?

A. ALT
B. AST
C. Alkaline phosphatase
D. GGT
E. NOTA

Cholestatic jaundice is suggested by the following
ratio of direct/indirect bilirubin?

A. >5%
B. >10%
C. >20%
D. >30%

Which liver function test measures synthetic function of the liver?

A. Partial throboplastin time
B. Albumin
C. Triglycerides
D. Cholesterol

A 16 y/o complains pain in the epigastric area. The
doctor suspects pancreatitis secondary to trauma. It started 9 days ago which aggravates every time he eats. Which of the following is elevated?

A. Lipase
B. Amylase
C. ALT
D. AST

Loss of appetite or anorexia is a common complaint among the elderly. Which of the following is NOT considered a contributing factor to anorexia?

A. Decrease in taste buds
B. Decrease in scent receptors
C. Dentition problems
D. Change in chemical content of saliva

At which time of the day is the basal rate of acid
secretion the greatest?

A. Night
B. AM
C. PM
D. Noon

Which of the following is responsible for the
impaired chewing mechanism in the elderly?

A. Diminution of masticatory muscle bulk
B. Decrease in saliva
C. Depression
D. Increase in fibrofatty tissues

Which of the following tastes predominate in the
elderly?

A. Sweet and salty
B. Umami and salty
C. Bitter and sour
D. NOTA

Which of the following does not decrease with age?

A. Amylase
B. Lipase
C. Bicarbonate
D. Insulin

Not a risk factor for colon cancer development in the elderly:

A. Increased proliferative rate
B. Broadened proliferative zone
C. Crypt hyperplasia
D. Circular muscle hypertrophy

A 40 y/o female consulted the OPD for abdominal
pain. You noted that she looks thin. You want to
know her weight but the only bathroom scale in OPD is not working. You have a stadiometer to measure her height. What is her DBW using Broca’s method using the height you obtained? (5 feet and 4 inches)

A. 43 kg
B. 48 kg
C. 52 kg
D. 56 kg

T/F: Gravity affects the transit of food

T/F: Longitudinal muscle make up the pyloric sphincter

T/F: Protein digestion begins in the mouth

Which part of the nervous system is involved in digestion?

Enteric nervous system

At what phase of migratory motor complex does the gallbladder start to empty?

A. Phase I
B. Phase II
C. Phase III
D. Phase IV

Which sympathetic ganglion predominantly supplies the stomach?

Celiac ganglion

Which part of the GI tract is very active during fasting?

Small intestine

Swallowing causes which of the following?

A. Relaxation of the orad stomach
B. Decreased secretion of secretin
C. Constriction of the LES
D. Sexual arousal

Reservoir function of the stomach is served by the:

Fundus

Primary drug in the management of GERD

Proton Pump inihibitors

What is the most common cause of GERD?

Transient LES Relaxation

Duodenal acidity stimulates enterogastric reflex by secreting:

Secretin

Which part of the colon acts as a volitional reservoir?

A. Ascending
B. Transverse
C. Descending
D. Rectosigmoid

Which of the following monosaccharides would be absorbed second?

a. glucose
b. galactose
c. fructose
d. mannose

Pepsin will degrade ingested proteins into the following except:

A. Peptone
B. Dipeptides
C. Amino Acids
D. NOTA

Triglyceride is digested into:

Monoglycerides and fatty acids

Triglycerides are formed in what part of the enterocyte?

Endoplasmic reticulum

This vitamin needs gastric intrinsic factor for absorption

B12

What factor would increase calcium absorption?

Active Vitamin D

What factor would increase iron absorption?

Ascorbic acid

Which of the following substances is absorbed by facilitated diffusion?

A. Galactose
B. Glucose
C. Fructose
D. Dipeptides

Which carrier protein is responsible for absorption of fructose and glucose accros the basolateral membrane?

GLUT 2

Sodium absorption in the distal colon involves which absorptive carrier?

Epithelial Sodium Channel

The process involving the combination of digestion and absorption of major nutrients

Assimilation

Absorption usually occurs in the

A. Esophagus
B. Stomach
C. Proximal small bowel
D. Transverse colon

Which is true regarding salivary secretion?

a. under exclusive hormonal control
b. condition and uncondition reflex
c. inhibited by sympathetic stimulation
d. it is induced by sleep

Approximately how much saliva produced daily

1.5L

The process where food is broken down into simple substances absorbed in the blood.

A. Ingestion
B. Digestion
C. Processing
D. Divertion

What gastric cell produces gastric lipase?

Chief cell

Vagal stimulation releases acetylcholine on all of the following cells, EXCEPT:

A. Chief cell
B. G cell
C. Parietal cell
D. ECL cell

Which phase has the least acid secretion?

A. Cephalic
B. Gastric
C. Intestinal
D. Hepatic

Which pancreatic cell produces digestive enzymes?

Acinar cell

Most important inorganic product of pancreatic secretion is:

GI hormone that best stimulates production of increased water and bicarbonate in the pancreas:

Secretin

Brunner’s glands secrete this substance that activates trypsin

A. Mucus
B. Glucagon
C. Neurotensin
D. Enterokinase

Excretory product of liver

Bilirubin

Which of the following bile acids are secondary bile acids?

A. Cholic and chenodeoxycholic
B. Lithocholic and cholic
C. Cholic and deoxycholic
D. Lithocholic and deoxycholic

Which is the predominant bile acid absorbed in the ileum for enterohepatic circulation

Deoxycholic

Transport protein responsible for uptake of bile acids in the basolateral membrane (sodium dependent)

Sodium torocholic cotransporter

Which GI hormone causes gallblader contraction and relaxation of sphincter of Oddi

CCK

Common PE finding in patients with acute cholecystisis

Murphy’s sign

A hard nodular liver may indicate:

Hepatocellular carcinoma

Shifting dullness is associated with abdominal enlargement due to:

Fluid

Which of the following tests can be used to assess the presence of hepatic injury?

A. serum albumin
B. serum bilirubin
C. sgpt/slt (ALT)
D. prothrombin time

What subsequent blood test should be requested if a patient has elevated gamma glutamin transpeptidase to determine if it is due to a
hepatic disorder?

alkaline phosphatase

Which two tests are used to diagnose cholestasis?

A. Conjugated bilirubin and prothrombin time
B. Prothrombin time and serum albumin
C. Alkaline phosphatase and serum albumin
D. Conjugated bilirubin and serum albumin

What is the cut off BMI for obesity in Western countries?

Cut off for waist circumference for females in Asian population

18cm

American heart association suggests cholesterol intake for patients with heart disease should be limited to:

200 mg/day

Salivary secretion:

A. increased with age
B. decreased with age
C. no change with aging

Gastric emptying:

A. increased with age
B. decreased with age
C. no change with aging

Small intestinal absorption:

A. increased with age
B. decreased with age
C. no change with aging

Gastric mucosal barrier:

A. increased with age
B. decreased with age
C. no change with aging

Constipation:

A. increased with age
B. decreased with age
C. no change with aging

A 35-year old woman with recent breast cancer diagnosis reports gastrointestinal distress following chemotherapy treatments targeting fast-replicating cells. Which GI layer or signaling molecule is most likely affected by the treatment?

A. Longitudinal muscle
B. Submucosal plexus
C. Epithelium
D. Motilin
E. Vasoactive Intestinal Peptide
F. NOTA

Which of the following gastrointestinal signaling substances is released by sympathetic nerve terminals and decreases intestinal secretions?

A. Substance P
B. VIP
C. Gastrin-releasing peptide
D. Neuropeptide Y
E. Histamine
F. NOTA

A 40-year old man with uncontrolled Crohn disease undergoes an ileal resection to remove damaged tissue. Synthesis and release of which gastrointestinal hormone will be most affected by this surgery?

A. Gastrin
B. Motilin
C. Glucose-dependent insulinotropic peptide
D. Prostaglandin
E. CCK

Which of the following describes the intestinal cells of Cajal?

A. They generate 15-20 cycles/min
B. They require voltage-gated Na channels
C. They require voltage-gated Ca channels
D. Depolarization is limited to the antrum
E. Depolarization is initiated in the fundus

If D cell function were inhibited by immune or inflammatory mediators, acid secretion would increase through which of the following mechanisms?

A. Reduced potentiation
B. Increased Ach
C. Increased prostaglandin 
D. Decreased G cell secretion
E. Loss of parietal cell inhibition
F. NOTA

Which of the following explains how the duodenum protects itself against ulcer formation?

A. It has a thick layer of viscous mucous
B. It has a thick apical membrane
C. S cells release secretin
D. ECL cells release histamine
E. Peptidases are released in active form

Na+ is required for absorption of which of the following substances by the small intestinal epithelium?

A. Apical fructose uptake
B. Basolateral glucose transport
C. Apical dipeptide uptake
D. Basolateral amino acid transport
E. NOTA

Gallstones obstructing the common bile duct would most affect the digestion and absorption of which of the following meal plans?

A. 55% carbohydrate, 15% protein, 30% fat
B. 20% carbohydrate, 30% protein, 50% fat
C. 70% carbohydrate, 10% protein, 20% fat
D. All the meal plans will be equally affected

Damage to the pudendal nerve will most likely affect which sphincter?

A. Pyloric
B. Ileocecal
C. Rectosigmoid
D. IAS
E. EAS

Compared with liver bile, gallbladder bile has:

A. Lower bile salt concentration
B. Lower fatty acid concentration
C. Lower cholesterol concentration
D. Higher bilirubin concentration
E. Higher Cl- concentration
F. NOTA

To evaluate possible cholecystitis, CCK is given during a procedure wherein biliary secretions are radioactively labelled and tracked. What is the primary function of CCK in this procedure?

A. To decrease primary bile salt formation
B. To decrease secondary bile salt formation
C. To stimulate local sympathetic efferents
D. To inhibit bicarbonate secretion
E. To contract the gallbladder
F. NOTA
G. AOTA

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